切换至 "中华医学电子期刊资源库"

中华消化病与影像杂志(电子版) ›› 2023, Vol. 13 ›› Issue (01) : 39 -45. doi: 10.3877/cma.j.issn.2095-2015.2023.01.008

综述

新辅助化疗在结直肠癌治疗中的应用
杜莹1, 曹莉莉2,()   
  1. 1. 250014 济南,山东大学山东省千佛山医院肿瘤学
    2. 250014 济南,山东大学山东省千佛山医院肿瘤学;250014 济南,山东第一医科大学第一附属医院(山东省千佛山医院)肿瘤学;250014 济南,山东省风湿免疫病转化医学重点实验室
  • 收稿日期:2022-05-06 出版日期:2023-02-01
  • 通信作者: 曹莉莉
  • 基金资助:
    山东省自然科学基金(ZR2020MH203); 山东省中医药科技发展计划(2019-0378); 山东第一医科大学第一附属医院培育基金(QYPY2019NSFC1015)

Application of neoadjuvant chemotherapy in the treatment of colorectal cancer

Ying Du1, Lili Cao2()   

  1. 1. Department of Oncology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, China
    2. Department of Oncology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 250014, China; Department of Oncology, First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250014, China; Shandong Provincial Key Laboratory for Rheumatic Disease and Translational Medicine, Jinan 250014, China
  • Received:2022-05-06 Published:2023-02-01
  • Corresponding author: Lili Cao
引用本文:

杜莹, 曹莉莉. 新辅助化疗在结直肠癌治疗中的应用[J/OL]. 中华消化病与影像杂志(电子版), 2023, 13(01): 39-45.

Ying Du, Lili Cao. Application of neoadjuvant chemotherapy in the treatment of colorectal cancer[J/OL]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(01): 39-45.

结直肠癌是全球范围内第三种最常见的恶性肿瘤,是第二大癌症死亡原因,手术为主要治疗方法。由于早期结直肠癌症状不明显,大部分患者发现时已错失手术机会。对于肿瘤可切除患者,采取新辅助化疗,提高局部控制率和整体生存率;对于肿瘤不可切除患者,采取转化治疗,将其转变为可切除状态,随后行手术切除。新辅助化疗适用于肿瘤中期患者以及手术切除难度较大、不易完全切除的肿瘤,可使瘤体降期,使肿块缩小,以利于后续的手术、放疗等治疗。国内外研究发现,术前新辅助化疗有助于手术切除率的提高,并且使患者术后生存期得以延长。本文就新辅助化疗治疗结直肠癌的应用原则、疗效评估、临床获益及风险进行综述。

Colorectal cancer(CRC)is the third most common malignant tumor in the world and the second most common cause of cancer death.Surgery is the main treatment.Because the symptoms of colorectal cancer are not obvious in the early stage, most patients have missed the opportunity of surgery.For patients with resectable tumors, neoadjuvant chemotherapy is used to improve local control rate and overall survival rate.For patients with unresectable tumors, transformation therapy is used to transform them into resectable state, followed by surgical resection.Neoadjuvant chemotherapy is suitable for patients with tumor in middle stage or difficult to be resected as well as difficult to be removed completely.It can reduce the tumor stage and make the tumor shrink so as to facilitate subsequent surgery and radiotherapy.Domestic and foreign studies have found that preoperative neoadjuvant chemotherapy contributes to the improvement of surgical resection rate and prolongs postoperative survival of patients.This article reviews the application principles, efficacy evaluation, clinical benefits and risks of neoadjuvant chemotherapy in the treatment of colorectal cancer.

1
唐军,杨静芳.新辅助化疗治疗直肠癌的研究现状[J].基层医学论坛201923(1):124-125.
2
Kollings FT.Diagnostics and Epidemiology of Colorectal Cancer [J].Visceral Medicine201632(3):158-164.
3
NCCN clinical practice guidelines in oncology:Colon Cancer(2020 version 1)[EB/OL].(2019-12-19).

URL    
4
Siegel RLMiller KDGoding Sauer A.Colorectal cancer statistics,2020 [J].CA Cancer J Clin202070(3):145-164.
5
樊嘉,顾晋,秦新裕,等.中国结直肠癌肝转移诊断和综合治疗指南(2020)[J].中国临床医学202128(1):129-144.
6
Modest DPPant SSartore-BianchiI A.Treatment sequencing in metastatic colorectal cancer [J].Eur J Cancer2019109:70-83.
7
Zhu XTian XJi L,et al.A tumor microenvironment-specific gene expression signature predicts chemotherapy resistance in colorectal cancer patients [J].NPJ Precision Oncology20215(1):7.
8
Cercek ADos Santos Fernandes GRoxburgh CS,et al.Mismatch Repair-Deficient Rectal Cancer and Resistance to Neoadjuvant Chemotherapy [J].Clin Cancer Res202026(13):3271-3279.
9
Johnson RMQu XLin CF,et al.ARID1A mutations confer intrinsic and acquired resistance to cetuximab treatment in colorectal cancer [J].Nature Communications202213(1):5478.
10
Temraz SNassar FNasr R,et al.Gut Microbiome:A Promising Biomarker for Immunotherapy in Colorectal Cancer [J].Int J Mol Sci201920(17):4155.
11
Yu TGuo FYu Y,et al.Fusobacterium nucleatum Promotes Chemoresistance to Colorectal Cancer by Modulating Autophagy [J].Cell2017170(3):548-563.e16.
12
Chang CWLee HCLi LH,et al.Fecal Microbiota Transplantation Prevents Intestinal Injury,Upregulation of Toll-Like Receptors,and 5-Fluorouracil/Oxaliplatin-Induced Toxicity in Colorectal Cancer [J].Int J Mol Sci202021(2):386.
13
Liu TZhang XDu L,et al.Exosome-transmitted miR-128-3p increase chemosensitivity of oxaliplatin-resistant colorectal cancer [J].Molecular Cancer201918(1):43.
14
Wang KLiu MWang HW,et al.Mutated DNA Damage Repair Pathways Are Prognostic and Chemosensitivity Markers for Resected Colorectal Cancer Liver Metastases [J].Front Oncol202111:643375.
15
Liu GLai DJiang Y,et al.Demethylzeylasteral Exerts Antitumor Effects via Disruptive Autophagic Flux and Apoptotic Cell Death in Human Colorectal Cancer Cells and Increases Cell Chemosensitivity to 5-Fluorouracil [J].Anticancer Agents Med Chem202222(5):851-863.
16
Luo WLiu QChen X,et al.FXYD6 Regulates Chemosensitivity by Mediating the Expression of Na+/K+-ATPaseα1 and Affecting Cell Autophagy and Apoptosis in Colorectal Cancer [J].BioMed Research International20212021:9986376.
17
Guo JZheng JMu M,et al.GW4064 enhances the chemosensitivity of colorectal cancer to oxaliplatin by inducing pyroptosis [J].Biochemical and Biophysical Research Communications2021548:60-66.
18
Zhang YKang MZhang B,et al.m(6)A modification-mediated CBX8 induction regulates stemness and chemosensitivity of colon cancer via upregulation of LGR5 [J].Molecular Cancer201918(1):185.
19
Hervieu CVerdier MBarthout E,et al.A Label-Free Cell Sorting Approach to Highlight the Impact of Intratumoral Cellular Heterogeneity and Cancer Stem Cells on Response to Therapies [J].Cells202211(15):2264.
20
Soleimani AZahiri EEhtiati S,et al.Therapeutic potency of heat-shock protein-70 in the pathogenesis of colorectal cancer:current status and perspectives [J].Biochem Cell Biol201997(2):85-90.
21
Xing YJing HZhang Y,et al.MicroRNA-141-3p affected proliferation,chemosensitivity,migration and invasion of colorectal cancer cells by targeting EGFR [J].Int J Biochem Cell Biol2020118:105643.
22
Sun JYao NLu P,et al.Effects of mFOLFOX6 regimen combined with carrelizumab on immune function and prognosis in patients with microsatellite instability colorectal cancer [J].Cellular Molecular Biology202267(5):356-362.
23
Cao XLuo JZhao B,et al.Pathological complete response after neoadjuvant immunotherapy combined with chemotherapy in pediatric rectal carcinoma:A case report [J].Front Immunol202213:1036181.
24
Lin ZCai MZhang P,et al.Phase II,single-arm trial of preoperative short-course radiotherapy followed by chemotherapy and camrelizumab in locally advanced rectal cancer [J].J Immunother Cancer20219(11):e003554.
25
Zhou HWang YLin Y,et al.Preliminary Efficacy and Safety of Camrelizumab in Combination With XELOX Plus Bevacizumab or Regorafenib in Patients With Metastatic Colorectal Cancer:A Retrospective Study [J].Front Oncol202111:774445.
26
Li YJZhang LDong QS,et al.Short-term outcome of programmed cell death protein1(PD-1)antibody combined with total neoadjuvant chemoradiotherapy in the treatment of locally advanced middle-low rectal cancer with high risk factors[J].Chin J Gastrointest Surg202124(11):998-1007.
27
DIAGNOSIS,TREATMENT GUIDELINES FOR COLORECTAL CANCER WORKING GROUP C.Chinese Society of Clinical Oncology(CSCO)diagnosis and treatment guidelines for colorectal cancer 2018(English version)[J].Chin J Cancer Res201931(1):117-134.
28
赵洪川,高春.结直肠癌新辅助治疗疗效的评价标准[J].国际消化病杂201131(5):253-255.
29
Rubbia-Brandt LGiostra EBrezault C,et al.Importance of histological tumor response assessment in predicting the outcome in patients with colorectal liver metastases treated with neo-adjuvant chemotherapy followed by liver surgery [J].Ann Oncol200718(2):299-304.
30
Dbouk HATawil ANasr F,et al.Significance of CEA and VEGF as Diagnostic Markers of Colorectal Cancer in Lebanese Patients [J].Open Clin Cancer J20071:1-5.
31
Yakabe TNakafusa YSumi K,et al.Clinical significance of CEA and CA19-9 in postoperative follow-up of colorectal cancer [J].Ann Surg Oncol201017(9):2349-2356.
32
赵凌昆,王新,赵云波.FAP-α和SDF-1预测新辅助化疗结直肠癌病人预后的研究[J].牡丹江医学院学报202041(2):38-41,64.
33
Nasseri YLangenfeld SJ.Imaging for Colorectal Cancer [J].Surg Clin N Am201797(3):503-513.
34
韩超,陈新晖.磁共振弥散加权成像ADC值对结直肠癌放化疗疗效的评估价值[J].中国CT和MRI杂志202119(8):144-147.
35
Lech GSotwiński RSodkowski M,et al.Colorectal cancer tumour markers and biomarkers:Recent therapeutic advances [J].World J Gastroenterol201622(5):1745-1755.
36
Ribic CMSargent DJMoore MJ,et al.Tumor microsatellite-instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer [J].N Engl J Med2003349(3):247-257.
37
Sargent DJMarsoni SMonges G,et al.Defective mismatch repair as a predictive marker for lack of efficacy of fluorouracil-based adjuvant therapy in colon cancer [J].J Clin Oncol201028(20):3219-3226.
38
Tie JCohen JDWang Y,et al.Serial circulating tumour DNA analysis during multimodality treatment of locally advanced rectal cancer:a prospective biomarker study [J].Gut201968(4):663-671.
39
Bhangu JSBeer AMittlböck M,et al.Circulating Free Methylated Tumor DNA Markers for Sensitive Assessment of Tumor Burden and Early Response Monitoring in Patients Receiving Systemic Chemotherapy for Colorectal Cancer Liver Metastasis [J].Ann Surg2018268(5):894-902.
40
Sposato LALam YKarapetis C,et al.Observation of " complete clinical response" in rectal cancer after neoadjuvant chemoradiation:The Flinders experience [J].Asia Pac J Clin Oncol201814(6):439-445.
41
董亚军.外周血中性粒细胞、淋巴细胞及其比值在进展期直肠癌新辅助化疗中的疗效评估及临床意义[D].南充:川北医学院,2019.
42
Ciliberto DPrati URoveda L,et al.Role of systemic chemotherapy in the management of resected or resectable colorectal liver metastases:a systematic review and meta-analysis of randomized controlled trials [J].Oncol Rep201227(6):1849-1856.
43
Wang ZMChen YYChen FF,et al.Peri-operative chemotherapy for patients with resectable colorectal hepatic metastasis:A meta-analysis [J].Eur J Surg Oncol201541(9):1197-1203.
44
Wang LJWang HWJin KM,et al.Comparative study on prognosis of neoadjuvant chemotherapy followed by hepatic surgery versus upfront surgery in patients with synchronous colorectal liver metastasis[J].Chin J Gastrointest Surg202124(3):248-255.
45
张卫刚.新辅助同步放化疗联合诱导化疗、巩固化疗治疗局部进展期直肠癌的临床研究[D].上海:第二军医大学,2017.
46
Khoo EO′Neill SBrown E,et al.Systematic review of systemic adjuvant,neoadjuvant and perioperative chemotherapy for resectable colorectal-liver metastases [J].HPB(Oxford)201618(6):485-493.
47
Brandi GDe Lorenzo SNannini M,et al.Adjuvant chemotherapy for resected colorectal cancer metastases:Literature review and meta-analysis [J].World J Gastroenterol201622(2):519-533.
48
Araujo RLGönen MHerman P.Chemotherapy for patients with colorectal liver metastases who underwent curative resection improves long-term outcomes:systematic review and meta-analysis [J].Ann Surg Oncol201522(9):3070-3078.
49
Araujo RGonen MAllen P,et al.Comparison between perioperative and postoperative chemotherapy after potentially curative hepatic resection for metastatic colorectal cancer [J].Ann Surg Oncol201320(13):4312-4321.
50
付尚志,张佳节,李万平.直肠癌术前新辅助放化疗研究进展[J].临床军医杂志201543(4):409-412.
51
Bhudia JGlynne-Jones RSmith T,et al.Neoadjuvant Chemotherapy without Radiation in Colorectal Cancer [J].Clin Colon Rectal Surg202033(5):287-297.
52
Kemeny NENiedzwiecki DHollis DR,et al.Hepatic arterial infusion versus systemic therapy for hepatic metastases from colorectal cancer:a randomized trial of efficacy,quality of life,and molecular markers(CALGB 9481)[J].J Clin Oncol200624(9):1395-1403.
53
Benoist SBrouquent APenna C,et al.Complete response of colorectal liver metastases after chemotherapy:does it mean cure? [J].J Clin Oncol200624(24):3939-3945.
54
Leonard GDBrenner BKemeny NE.Neoadjuvant chemotherapy before liver resection for patients with unresectable liver metastases from colorectal carcinoma [J].J Clin Oncol200523(9):2038-2048.
55
Van Vledder MGDe Jong MCPawlik TM,et al.Disappearing colorectal liver metastases after chemotherapy:should we be concerned? [J].J Gastrointest Surg201014(11):1691-1700.
56
Bischof DAClary BMMaithel SK,et al.Surgical management of disappearing colorectal liver metastases [J].Br J Surg2013100(11):1414-1420.
57
Bilchik AJPoston GCurley SA,et al.Neoadjuvant chemotherapy for metastatic colon cancer:a cautionary note [J].J Clin Oncol200523(36):9073-9078.
58
Hubert CLucidi VWeerts J,et al.Impact of biological agents on the prevalence of chemotherapy associated liver injury(CALI):Multicentric study of patients operated for colorectal liver metastases [J].Eur J Surg Oncol201844(10):1532-1538.
59
ViganòLCapussotti LDe Rosa G,et al.Liver resection for colorectal metastases after chemotherapy:impact of chemotherapy-related liver injuries,pathological tumor response,and micrometastases on long-term survival [J].Ann Surg2013258(5):731-740.
60
Choti MA.Chemotherapy-associated hepatotoxicity:do we need to be concerned? [J].Ann Surg Oncol200916(9):2391-2394.
61
Kishi YZorzi DContreras CM,et al.Extended preoperative chemotherapy does not improve pathologic response and increases postoperative liver insufficiency after hepatic resection for colorectal liver metastases [J].Ann Surg Oncol201017(11):2870-2876.
62
Rubbia-Brandt LAudard VSartoretti P,et al.Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer [J].Ann Oncol200415(3):460-466.
63
Vauthey JNPawlik TMRibero D,et al.Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases [J].J Clin Oncol200624(13):2065-2072.
64
Adam RVinet E.Regional treatment of metastasis:surgery of colorectal liver metastases [J].Ann Oncol200415(4):103-106.
65
葛大壮,赵建军,黄振,等.MDT指导下多程治疗直肠癌肝转移临床治愈一例[J/OL].肝癌电子杂志20196(3):24-27.
66
Zhao JVan Mierlo KMCGómez-Ramírez J,et al.Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases [J].Br J Surg2017104(8):990-1002.
[1] 洪玮, 叶细容, 刘枝红, 杨银凤, 吕志红. 超声影像组学联合临床病理特征预测乳腺癌新辅助化疗完全病理缓解的价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 571-579.
[2] 王聪, 李云涛, 唐甜甜, 王鑫蕊, 吕鑫, 范志刚. 多基因检测对激素受体阳性、HER-2阴性乳腺癌新辅助化疗疗效预测的研究进展[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(05): 292-296.
[3] 罗青杉, 梅海涛, 郝家领, 蔡锦锋, 周润楷, 温玉刚. 连接蛋白43通过调控细胞周期抑制结直肠癌的增殖机制研究[J/OL]. 中华普通外科学文献(电子版), 2024, 18(05): 344-349.
[4] 徐逸男. 不同术式治疗梗阻性左半结直肠癌的疗效观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 72-75.
[5] 许杰, 李亚俊, 冯义文. SOX新辅助化疗后腹腔镜胃癌D2根治术与常规根治术治疗进展期胃癌的近期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 647-650.
[6] 张昊, 潘卫东. 胰腺癌新辅助化疗后可切除性评估现状及进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 629-633.
[7] 严虹霞, 王晓娟, 张毅勋. 2 型糖尿病对结直肠癌患者肿瘤标记物、临床病理及预后的影响[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 483-487.
[8] 赵磊, 刘文志, 林峰, 于剑, 孙铭骏, 崔佑刚, 张旭, 衣宇鹏, 于宝胜, 冯宁. 深部热疗在改善结直肠癌术后辅助化疗副反应及生活质量中的作用研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 488-493.
[9] 黄海洋, 邝永龙, 陈嘉胜. 基层医院结直肠肿瘤经自然腔道取标本手术30 例分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 510-518.
[10] 韩加刚, 王振军. 梗阻性左半结肠癌的治疗策略[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 450-458.
[11] 石阳, 于剑锋, 曹可, 翟志伟, 叶春祥, 王振军, 韩加刚. 可扩张金属支架置入联合新辅助化疗治疗完全梗阻性左半结肠癌围手术期并发症分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 464-471.
[12] 梁轩豪, 李小荣, 李亮, 林昌伟. 肠梗阻支架置入术联合新辅助化疗治疗结直肠癌急性肠梗阻的疗效及其预后的Meta 分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 472-482.
[13] 张蔚林, 王哲学, 白峻阁, 黄忠诚, 肖志刚. 利用TCGA数据库构建基于miRNA的结直肠癌列线图预后模型[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 381-388.
[14] 张伟伟, 陈启, 翁和语, 黄亮. 随机森林模型预测T1 期结直肠癌淋巴结转移的初步研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(05): 389-393.
[15] 张梦婷, 穷拉姆, 色珍, 李逸群, 德庆旺姆. 西藏地区藏族乳腺癌新辅助化疗的真实世界研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 441-446.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?